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v1.0.0
ICD-10 Guide
ICD-10 CodesK85.8

K85.8

Non-billable

Other acute pancreatitis

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 K85.8 is a used to indicate a diagnosis of other acute pancreatitis.

Key Diagnostic Point:

K85.8 refers to 'Other acute pancreatitis,' a condition characterized by the sudden inflammation of the pancreas, which can result from various etiologies not classified under other specific codes. The pancreas, located behind the stomach, plays a crucial role in digestion and blood sugar regulation. Clinical presentation may include severe abdominal pain, nausea, vomiting, fever, and elevated heart rate. The disease can progress rapidly, leading to complications such as necrotizing pancreatitis, pancreatic abscess, or systemic inflammatory response syndrome (SIRS). Diagnostic considerations include imaging studies like CT scans or MRIs, laboratory tests showing elevated pancreatic enzymes (amylase and lipase), and a thorough patient history to identify potential causes such as alcohol consumption, medication use, or metabolic disorders. Accurate diagnosis is essential for effective management and treatment, which may involve hospitalization, supportive care, and addressing the underlying cause of the pancreatitis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors
  • Documentation gaps
  • Billing challenges

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Internal Medicine

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Acute pancreatitis, including cases classified under K85.8, has significant clinical implications, affecting patient morbidity and healthcare utilization. It can lead to prolonged hospital stays and increased healthcare costs. Understanding the epidemiology of acute pancreatitis, including its risk factors and complications, is vital for improving patient outcomes and quality measures in healthcare settings.

ICD-9 vs ICD-10

Acute pancreatitis, including cases classified under K85.8, has significant clinical implications, affecting patient morbidity and healthcare utilization. It can lead to prolonged hospital stays and increased healthcare costs. Understanding the epidemiology of acute pancreatitis, including its risk factors and complications, is vital for improving patient outcomes and quality measures in healthcare settings.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the condition, length of hospital stay, and any complications that arise. Common denials may occur if documentation does not clearly support the diagnosis or if the treatment provided does not align with the billed services. Best practices include ensuring that all clinical notes are thorough and that coding accurately reflects the patient's condition and treatment plan.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by K85.8?

K85.8 encompasses acute pancreatitis cases that do not fall under the specific categories of K85.0 (alcohol-related) or K85.1 (gallstone-related). This may include drug-induced pancreatitis, hereditary pancreatitis, or pancreatitis due to metabolic disorders.

When should K85.8 be used instead of related codes?

K85.8 should be used when the acute pancreatitis is not attributable to alcohol or gallstones and when the cause is unknown or classified as 'other.' It is essential to document the specific etiology when available.

What documentation supports K85.8?

Documentation should include clinical findings, laboratory results indicating elevated pancreatic enzymes, imaging studies confirming inflammation, and a detailed patient history to support the diagnosis of acute pancreatitis.